Preoperative statin therapy in cardiac surgery: a meta-analysis of 90,000 patients
Abstract
The objective of this systematic literature review with meta-analysis was to determine the strength of evidence for a preoperative statin on the reduction of adverse postoperative outcomes in patients undergoing cardiac surgery. Randomized controlled (RCT) and observational trials were searched in online databases that reported about the effects of preoperative statin therapy on major adverse clinical outcomes after cardiac surgery. Analysed outcomes included early all-cause mortality, myocardial infarction, atrial fibrillation (AF), stroke and renal failure using a priori-defined criteria. Effect estimates were calculated and are given as odds ratio (OR) with 95% confidence intervals (95% CI) using fixed- or random-effect models. Literature search of all major databases retrieved 2371 studies. After screening, a total of 54 trials were identified (12 RCT, 42 observational) that reported outcomes of 91 491 cardiac surgery patients with (n = 46 614; 51%) or without (n = 44 877; 49%) preoperative statin therapy. Preoperative statin use resulted in a 0.9% absolute risk (2.6 vs 3.5%) and a 31% odds reduction for early all-cause mortality (OR 0.69; 95% CI 0.59-0.81; P < 0.0001). In addition, statin treatment before surgery was associated with a substantial reduction (P < 0.01) in the postoperative end-points AF (OR 0.71; 95% CI 0.61-0.82), new-onset AF (OR 0.68; 95% CI 0.54-0.85), stroke (OR 0.83; 95% CI 0.74-0.93), stay on intensive care unit (weighted mean difference [WMD] -0.14; 95% CI -0.23 to -0.03; P < 0.01) and in-hospital stay (WMD -0.57; 95% CI -0.76 to -0.38; P < 0.01). No statistical differences were found between groups with regard to myocardial infarction or renal failure. In conclusion, the current systematic review strengthens the evidence that preoperative statin therapy extends substantial clinical benefit to early postoperative outcomes in cardiac surgery patients.
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Perioperative statin therapy appeared to reduce the risk of postoperative atrial fibrillation in a number of small randomized controlled trials.
“Perioperative statin therapy appeared to reduce the risk of postoperative AF in a number of small RCTs 689,690”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [690]
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- Authors
- Kuhn, E. W., Liakopoulos, O. J., Stange, S., Deppe, A.-C., Slottosch, I., Choi, Y.-H., & Wahlers, T.
- Affiliations
- University of Cologne (DE)
- Corresponding author
- Liakopoulos, Oliver J.
- Venue
- European Journal of Cardio-Thoracic Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-04-05
- Volume
- 45
- Issue
- 1
- Pages
- 17-26
- ISSN
- 1010-7940 (ISSN-L)
- 1873-734X
- OpenAlex
- W2149111184
- Cited by
- 114
- References
- 76
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 7 · 2021: 5 · 2020: 9 · 2019: 6 · 2018: 8 · 2017: 14 · 2016: 20 · 2015: 13 · 2014: 10 · 2013: 4
- FWCI
- 2.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Cardio-Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- preoperative statin therapy, cardiac surgery, all-cause mortality, atrial fibrillation, postoperative stroke, ICU length of stay, length of hospital stay, myocardial infarction, renal failure, statins, hypercholesterolemia, dyslipidemia, hypertriglyceridemia, hyperglycemia
- MeSH terms
- Coronary Artery Bypass, Atrial Fibrillation, Cardiac Surgical Procedures, Humans, Length of Stay, Myocardial Infarction, Postoperative Complications, Preoperative Care, Treatment Outcome, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Renal Insufficiency
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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